Medical Reiki Course Application

Tell Margaret Mary About yourself

Section 1: Personal Information

First Name *

Last Name *

Date of birth

Place of Birth

Time of Birth

Phone

Email *

City

State

Country

Postal Code

Section 2: Reiki Training & Documentation

List Reiki Certifications, Experience, and Training Including Dates *

After submitting the form you will be asked to email copies of your documentation and certificates to Margaret Mary for verification.

Section 3: Reiki Symbols

List Reiki Symbols you are attuned, activated, ignited, or initiated to *

After submitting this form please email Margaret Mary with your drawn images of the Reiki symbols you have listed.

Section 4: Application Questions

1. What motivated you to pursue training in Medical Reiki, and how do you envision integrating it into your current or future professional practice? *

2. Please describe any previous experience or formal training you have with Reiki or other energy healing modalities. *

3. Have you had experience working in medical or healthcare environments? If so, please elaborate on your role and responsibilities. *

4. What are your expectations for this program, and what specific goals do you hope to achieve by completing it? *

5. How do you plan to support patients, families, and medical staff as a Medical Reiki practitioner? *

6. Are you comfortable working in emotionally charged or high-stress medical settings? Please provide examples if applicable. *

7. Is there anything else you would like us to know about your background, skills, or interest in Medical Reiki? *

Section 5: Agreement

By signing and submitting this application, I acknowledge I am requesting acceptance into an advanced four-year Medical Reiki Training Program which meets once a week for four hours.

Signature *

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